Περίληψη:
In patients with rheumatic diseases undergoing immunosuppressive treatment, hepatitis B virus reactivation (HBVr) has been long recognized as a major treatment-related adverse event with substantial morbidity and mortality. Because HBVr is easily preventable with appropriate screening and monitoring strategies, and, when indicated, prophylactic antiviral treatment, awareness of this complication is of the utmost importance, especially in the era of biologic treatments. As a condition, it continues to be topical, in view of the emergence of novel classes of immunosuppressive drugs (i.e. Janus kinase inhibitors) acquiring licenses for a variety of rheumatic diseases. The class-specific risk of these agents for HBVr has not yet been determined. Moreover, ambiguity still exists for the management of patients planned to be treated with traditional agents, such as cyclophosphamide and glucocorticoids, particularly in the setting of resolved HBV infection. Clinicians in the field of rheumatic diseases should be tailoring their practice according to the host’s profile and treatment-specific risk for HBVr. In this review, the authors attempt to critically review the existing literature and provide practical advice on these issues. © The Author(s), 2020.
Συγγραφείς:
Koutsianas, C.
Thomas, K.
Vassilopoulos, D.
Λέξεις-κλειδιά:
azathioprine; baricitinib; cyclophosphamide; cytokine receptor antagonist; disease modifying antirheumatic drug; glucocorticoid; guselkumab; hepatitis B core antibody; hepatitis B surface antibody; hepatitis B surface antigen; hepatitis B(e) antibody; hepatitis B(e) antigen; hydroxychloroquine; immunoglobulin M; interleukin 17 receptor; interleukin 6; Janus kinase inhibitor; leflunomide; methotrexate; mycophenolate mofetil; ocrelizumab; ofatumumab; risankizumab; rituximab; salazosulfapyridine; tildrakizumab; tofacitinib; ustekinumab; virus DNA, age; delta agent hepatitis; gender; genotype; hepatitis B; Hepatitis B virus; hepatitis C; human; Human immunodeficiency virus infection; immunosuppressive treatment; infection risk; liver cirrhosis; mixed infection; Review; rheumatic disease; rheumatoid arthritis; screening; serology; treatment duration; vaccination; virus load; virus reactivation
